Well, ostensibly, the reason that those rules exist is, ultimately, to protect patients. There are, I'm sure, frivolous lawsuits against doctors, but the ones that his insurer is probably more worried about are the ones that are perfectly legitimate. And if the doctor performed an exam, those problems are less likely to occur. And there is no reason, I don't suppose, that it couldn't be handled over the phone (I think this is the way some doctors work in deepest Alaska) but he'd charge you the same amount. It's still the same use of his time.